The choice of treatment of single brain metastasis should be based on extracranial tumor activity and age

Presentation, patterns of care, and survival in patients with brain metastases

“…More aggressive local treatment influences survival of patients with brain metastases from different primary tumors Andrews et al, 11 Kondziolka et al, 12 Noordijk et al, 13 Patchell et al 14 These randomized trials have demonstrated the superiority of WBRT plus SRS or surgery compared with WBRT alone Systemic treatment influences survival of patients with brain metastases from different primary tumors None No published randomized trials support this hypothesis Survival of the historical cohort analyzed here is comparable to representative large cohorts from the 1980s…”

“…Utilization of these focal therapies increased from 17% to 31%. Based on the 1-year survival rates around 40% reported in randomized trials of WBRT plus SRS or surgery, [11][12][13][14] the increased utilization of these methods by 14% can be modeled to predict at most a 23% 1-year survival in the contemporary group. The remaining component of improvement has to be accounted for by other changes, including the effect of systemic treatment, and also early diagnosis due to the use of brain MR screening for staging.…”

Efficacy of Surgical Treatment for Brain Metastasis in Patients With Non-small Cell Lung Cancer

“…6 Until now, treatment for brain metastases includes surgery, SRS, WBRT, or a combination of these modalities, and has achieved median survival ranging from 6.5 to 11.0 months. [28][29][30][31][32] In our present study, neurosurgery group showed no significant differences in survival rate (OS, 12.1 months) compared with non-neurosurgery group (OS, 10.2 months) (Table 4), and showed a favoring trend with 1.9 months, even though patients with a poor prognostic factor (RPA class II or III) were included, compared with the previous data. 28,32 A previous study showed a prolonged survival only in patients in the AS group compared to symptomatic synchronous patients.…”

Solitary Hypothalamus Triple Negative Metastasis from Luminal: A Primary Breast Carcinoma

“…Patients in the combined-modality arm achieved better local control (20% vs 52%; p: 0.02), improved median duration of functional independence (38 vs 8 weeks; p: 0.005), and longer overall survival (40 vs 15 weeks; p: 0.01), compared to the patients who received WBRT alone. These findings were replicated in a study of 63 patients (19% with breast primaries) led by Noordijk et al [29], in which patients treated with surgery and WBRT achieved prolonged survival (median 10 vs 6 months; p: 0.04) and functionally independent survival (7.5 vs 3.5 months; p: 0.06) compared to patients treated with WBRT alone. Of note, only patients with stable or absent extracranial disease appeared to derive a survival benefit from surgery; patients with progressive extracranial disease experienced a median survival of only 5 months irrespective of the allocated treatment.…”